A Glenn procedure is the surgical procedure of the heart that is performed in newborn babies when the normal blood flow of the heart is disturbed due to some issue. The Glenn procedure makes a new pathway of the blood flow which bypasses the affected area of the heart and directs the blood directly into the lungs for the oxygenation of blood. When the heart is not functioning properly and does not provide enough oxygen to the whole body, the Glenn procedure is performed to restore the blood flow which allows the supply of oxygen to the whole body. The Glenn procedure is performed after 3 to 6 months of birth of the baby and it may require another surgery after some years for the permanent solution of disturbed blood flow. There are many congenital conditions in which the Glenn procedure is performed. The Glenn procedure is rarely performed because it has some risks and complications. The Glenn procedure may require intensive care for a few days after the procedure. The recovery can vary but it generally takes a few months. The success rate of the Glenn procedure is about 99%. The Glenn procedure has improved the survival rate in babies for the past few years who are born with some congenital heart disease.
Types of Glenn Procedure Treatment India
Two types of Glenn procedures are used in clinical settings. These are:
- Bidirectional Glenn (BDG) Procedure
- Hemi-Fontan or Unidirectional Glenn Procedure
Bidirectional Glenn (BDG) Procedure
The Bidirectional Glenn procedure is usually performed as the second stage to restore the circulation. In this surgery, the blood vessels that carry deoxygenated blood are disconnected from the right upper chamber of the heart and connected directly to the blood vessels that carry blood to the lungs. This is done to make a new path for deoxygenated blood from the upper body directly into the lungs. It is an important step in the overall management of congenital heart defects because it does not allow the blood to pass through the affected area.
Hemi-Fontan or Unidirectional Glenn Procedure
The Hemi-Fontan procedure is another type of the Glenn procedure. In this surgery, the major blood vessel that carries deoxygenated blood from the upper body is connected to the right side of the blood vessel that carries blood to the lungs. It is usually done as an interim step before the complete Fontan procedure. This modification allows for improved oxygenation and reduced load on the one lower chamber of the heart. It is suitable for complex types of congenital heart conditions.
Glenn Procedure
The overview of the Glenn procedure is described below:
• Anesthesia: The anesthesia is administered before the surgery so that the patient is unconscious throughout the procedure.
• Access: The surgeon makes an incision in the chest to access the blood vessels. The size and location of the incision can vary according to the patient or the preference of the surgeon.
• Cardiopulmonary Bypass: In some cases, the patient may be put on a heart-lung machine which is used to perform the job of pumping blood for some time. It is a machine that is used in different types of heart and lung surgeries. This allows the surgeon to work on the heart without the need for the heart to beat.
• Isolation of blood vessels: The surgeon separates the large blood vessel that carries deoxygenated blood from the upper body to the heart.
• Anastomosis: The critical step of the Glenn procedure involves creating a connection between the isolated blood vessel that carries deoxygenated blood and the blood vessel that carries blood to the lungs. This connection allows deoxygenated blood from the upper body to flow directly into the lungs without passing to the affected area of the heart.
• Closure: After the Glenn procedure, the surgeon closes the incision with the help of sutures.
• Monitoring and Recovery: The patient is closely monitored after the operation to ensure normal blood flow. Recovery may vary from patient to patient but it can take several days in the hospital.
Cost of Glenn Procedure in India
The cost of Glenn Procedure in India ranges from 3000 USD to 4500 USD. The cost can vary according to different complications of congenital conditions of the heart. The cost can also vary according to the type of procedure used.
Glenn Procedure ; 3090 USD - 4120 USD
Indications of Glenn Procedure
Some of the heart conditions that are present in newborn babies in which the Glenn procedure is performed are:
- Hypoplastic Left Heart Syndrome
- Single Ventricle Heart Defects
- Pulmonary Atresia
- Tricuspid Atresia
- Double Inlet Left Ventricle
- Unbalanced Atrioventricular Septal Defect
- Complex Transposition of the Great Arteries
- Total Anomalous Pulmonary Venous Connection
- Pulmonary Stenosis
- Tetralogy of Fallot
- Truncus Arteriosus
- Congenitally Corrected Transposition of the Great Arteries
- Atrioventricular Canal Defect
- Pulmonary Hypertension
- Heart present on the right side
- Taussig-Bing Anomaly
- Congenital Heart Defects with Inadequate Mixing
Risk Factors of Glenn Procedure
Some of the risks that are associated with the Glenn Procedure are as follows:
Bleeding
The Glenn procedure is associated with the risk of bleeding. Excessive bleeding requires further treatments to manage the complication.
Infection
There is a risk of infection at the surgical site. The infection can also happen late after the surgery of the Glenn procedure.
Arrhythmias
Sometimes, the surgical procedure leads to the irregular rhythm of the heart which can lead to life-threatening conditions.
Fluid Accumulation
Fluid can accumulate in the heart and also in the structures close to the heart. It may require drainage and can complicate the healing.
Blood Clots
There is a risk of blood clot formation. The blood clots can enter the blood vessels and may reach the major organs like the lungs and brain which can be an emergency.
Low Oxygen Levels
While the Glenn procedure is performed to improve oxygen supply to the whole body, there can still be a risk of low oxygen levels in the blood.
Pleural Effusion
There is a risk of fluid accumulation in the cavity of the chest which can result in breathing problems.
Pulmonary Hypertension
There is the risk of high blood pressure in the lungs after the Glenn procedure which can lead to many complications.
Neurological Complications
In some rare cases, the Glenn procedure can lead to brain attack which is a complication of blood clot formation in the blood vessels.
Heart Failure
Although the Glenn procedure is performed to improve the functions of the heart, there can be a risk of heart failure or problems with the normal functioning of the heart.
Delayed Growth
Babis who are treated with the surgical procedure of Glenn has the risk of delayed growth.
 Digvijay Sharma.webp)
03/05/2024
